Family Planning: Empowering People, Developing Nations

UNFPA Rep. Dr. Robertson (second from left) with speakers from BKKBN, BPS Statistics Indonesia, Center for Population Study-Gadjah Mada University, Demographic Institute-University of Indonesia and the Ministry of Health.

Women from Sabang to Merauke are able to access contraceptives more easily these days, compared to women in the seventies when Indonesia started introducing the Family Planning programme. The country has been committed to helping couples to plan their families by providing different choices of contraceptives. The Family Planning programme has had beneficial impact on individuals, families and the nation. Families have fewer children, maternal and child health continues to improve, school participation and women’s participation in paid labour have increased, gender equality has been fostered and population growth has stabilized. Couples have for the most part been able to exercise their rights to plan the size of the family and to space and time their pregnancies. The national development progress we’ve seen today is closely linked to Indonesia’s strong resolve in implementing Family Planning programme since the 1970s.

What we have witnessed is the realization of the principles of the 1994 Cairo International Conference on Population and Development that brought a paradigm shift away from population control towards people-centered development through human rights, including reproductive health and rights; principles that are key to the attainment of the Sustainable Development Goals in 2030.

This week on July 11, 2017, policy makers, donors, and Family Planning (FP) advocates around the world gathered in London to discuss efforts to attain Family Planning 2020 goals of 120 million additional contraceptive users by the year 2020. This meeting coincided with the commemoration of the 2017 World Population Day whose theme was Family Planning: Empowering People, Developing Nations.

Family Planning is about empowering couples and individuals to actively exercise their rights to family planning by making informed decisions, and accessing quality rights-based Family Planning services, supplies and information, tailored to their needs. There are two elements to emphasize here. Firstly, the users: couples or individuals. For the users to be able to exercise their rights and develop behavior that protects their health and wellbeing, they need to be empowered with sound rights awareness, including young people’s rights, the rights to health, including sexual & reproductive health; and how, when, and where to access contraceptive services and information. And secondly, the services: the quality, accessibility, availability and affordability of Family Planning services and supplies that are rights-based and equitable.

Efforts to realize this requires innovative financing for sustainable Family Planning, especially in this changing global financial context. Also critical is strengthening the supply chain management (from forecasting contraceptive needs, procurement, logistics and distribution until it reaches the users), and expanding the range of contraceptives methods available for women and accessibility to contraceptive services, especially by the underserved communities and individuals, such as young people, and in humanitarian settings.

The London Summit called for greater investment in Family Planning throughout the world and stronger partnerships with the private sector, religious and community leaders, and civil society.

Family Planning is a cost-effective development investment. Guttmacher’s 2017 Adding It Up Study revealed that investment in expanding quality Family Planning services in developing regions is about $11 billion annually or $1.75 per person per year. An investment of $8.39 per person per year is needed to ensure that all women in developing regions have access to essential maternal-newborn care and quality Family Planning services. The investments in maternal-newborn care and Family Planning will result in a net savings of $7.1 billion, compared with investing in maternal and newborn health care alone. Continued technical and funding support by international development donors and partners remains crucial for the achievement of these global Family Planning initiatives.

According to PMA2020 survey in 2017, approximately 32 million women will be current users of modern contraception in Indonesia. Under the FP2020 framework, the Government of Indonesia is committed to add at least 700,000 additional users of modern contraception annually until 2020. As a result of contraceptive use, an estimated 9 million unintended pregnancies will be prevented and 3 million unsafe abortions will be averted each year. Despite these achievements, approximately 14 percent of married women who do not want to become pregnant, or want to limit or space their pregnancies are still finding it difficult to do so. In fact, around 2.5 million women of reproductive-age (3.6%) are still using unreliable traditional methods.

Despite the unfinished business, we can learn from the good practices of the past Family Planning implementation in Indonesia: including strong national to subnational commitment, budget allocation, building capacity of service providers and field facilitators, mobilizing voluntary community engagement and full ownership of Family Planning as a community development priority. Through fully supporting BKKBN’s community empowerment initiatives, like the Kampung KB; through linkages with initiatives by the Ministry of Health, including ensuring maximal expansion of Family Planning in the Universal Health Coverage scheme; and through supporting MOWECP women’s and girls’ empowerment initiatives; the National Rights-Based Family Planning Strategy can be fully implemented. Success stories from a coordinated approach where empowerment and rights are central to interventions would enable the country to accelerate achievement of its Family Planning goals and commitment.

Emboldened with its revitalized Family Planning programme and strong commitment, high level representatives from Ministries of Health and BKKBN participated in the DFID-UNFPA-Bill & Melinda Gates Foundation supported London Summit, sending a strong signal that the Government of Indonesia is committed to furthering rights-based, equitable Family Planning services and addressing the challenges through concrete policies and programme interventions. However, this can only be fully realized when all Family Planning advocates: donors, profession-based organizations, academia, private sector and elements of community – stand side by side in full support of government. The global meeting and a series of its satellite events conducted in provinces throughout Indonesia provide a strategic momentum for all Family Planning players throughout the country to renew their partnerships for strengthened multi-sectoral efforts towards rights-based, equitable Family Planning.

Furthermore, by supporting a Family Planning programme, based on the rights of individuals to have the number of children they want, and ensuring no-one is left behind; by facilitating policies that take into account the window of opportunity specific for districts and socioeconomic status; coupled with sound policies for innovative youth employment, gender equality and quality education, the benefits of harnessing the demographic bonus will be maximized in Indonesia.